2025 EVOLVE ELSEVIER HESI RN Medical-Surgical Exam
| 190 Practice Questions with Correct Answers &
Rationale | Based on Current Nursing Curriculum from
Chamberlain, Rasmussen, Aspen, WGU, Galen College
QUESTION 1
A nurse is caring for a patient with heart failure. Which dietary change should the
nurse recommend?
A) Increase sodium intake
B) Increase potassium intake
C) Decrease sodium intake (correct)
D) Decrease fluid intake
RATIONALE: A decrease in sodium intake helps manage fluid retention and blood
pressure in heart failure patients.
QUESTION 2
A patient is being treated for pneumonia. What is the priority nursing intervention?
A) Administer bronchodilators
B) Encourage fluid intake
C) Obtain a sputum culture (correct)
D) Provide oxygen therapy
RATIONALE: Obtaining a sputum culture is essential to identify the causative organism
and guide antibiotic therapy.
QUESTION 3
A nurse is teaching a patient about self-administration of insulin. Which statement
by the patient indicates a need for further teaching?
A) "I will rotate my injection sites."
B) "I can use any part of my body for injections."
C) "I will use the same site for every injection." (correct)
D) "I will keep my insulin in the refrigerator."
RATIONALE: Using the same site for every injection can lead to lipodystrophy; rotation
of sites is important.
QUESTION 4
A patient with diabetes is experiencing hypoglycemia. What is the priority action by
the nurse?
,A) Administer 15 grams of fast-acting carbohydrate (correct)
B) Administer glucagon
C) Call the physician
D) Provide a snack with protein
RATIONALE: Administering fast-acting carbohydrates quickly raises blood sugar levels,
which is the immediate need in hypoglycemia.
QUESTION 5
A patient is post-operative after a cholecystectomy. Which assessment finding
should the nurse report immediately?
A) Moderate abdominal pain
B) Nausea and vomiting
C) Rigid abdomen (correct)
D) Low-grade fever
RATIONALE: A rigid abdomen may indicate peritonitis or internal bleeding, which
requires immediate attention.
QUESTION 6
A nurse is caring for a patient with a newly placed tracheostomy. What is the
priority nursing intervention?
A) Provide humidified air
B) Suction the tracheostomy
C) Ensure the airway is patent (correct)
D) Change the tracheostomy ties
RATIONALE: Ensuring the airway is patent is the highest priority in patients with a
tracheostomy.
QUESTION 7
A patient with chronic obstructive pulmonary disease (COPD) is experiencing
shortness of breath. What is the best position for the nurse to assist the patient
into?
A) Supine
B) Lying flat
C) High Fowler's (correct)
D) Trendelenburg
,RATIONALE: High Fowler's position facilitates maximal lung expansion and eases
breathing in patients with COPD.
QUESTION 8
A nurse is assessing a patient with a suspected deep vein thrombosis (DVT). Which
assessment finding is most indicative of DVT?
A) Warmth and redness in the leg
B) Edema in the affected leg
C) Calf tenderness and swelling (correct)
D) Coolness of the extremity
RATIONALE: Calf tenderness and swelling are classic signs of DVT, prompting further
evaluation.
QUESTION 9
A patient with liver cirrhosis is at risk for bleeding. Which laboratory value should
the nurse monitor closely?
A) Hemoglobin
B) Hematocrit
C) Prothrombin time (PT) (correct)
D) Platelet count
RATIONALE: Prothrombin time is prolonged in liver disease due to impaired synthesis of
clotting factors.
QUESTION 10
A nurse is caring for a patient with a history of anaphylaxis. What is the most
important teaching point for this patient?
A) Avoid dairy products
B) Carry an EpiPen
C) Wear a medical alert bracelet (correct)
D) Limit exercise
RATIONALE: Wearing a medical alert bracelet informs others of the patient's allergy
history and the need for emergency intervention.
QUESTION 11
A patient with congestive heart failure is being discharged. What should the nurse
include in the discharge teaching?
, A) Increase fluid intake
B) Limit sodium intake
C) Weigh daily at the same time (correct)
D) Exercise vigorously
RATIONALE: Daily weight monitoring helps detect fluid retention early.
QUESTION 12
A nurse is caring for a patient receiving chemotherapy. Which finding requires
immediate intervention?
A) Nausea
B) Fever of 101°F (38.3°C) (correct)
C) Fatigue
D) Hair loss
RATIONALE: A fever indicates potential infection in immunocompromised patients,
requiring prompt action.
QUESTION 13
A patient with diabetes is learning about foot care. Which statement indicates a
need for further teaching?
A) "I will check my feet daily."
B) "I can use hot water to soak my feet." (correct)
C) "I should wear well-fitting shoes."
D) "I will report any sores to my doctor."
RATIONALE: Soaking feet in hot water can cause burns; this statement shows a lack of
understanding.
QUESTION 14
A nurse is monitoring a patient after a myocardial infarction. What is the priority
assessment?
A) Lung sounds
B) Heart rate
C) Blood pressure (correct)
D) Temperature
RATIONALE: Blood pressure is critical to monitor for potential complications like
cardiogenic shock.
| 190 Practice Questions with Correct Answers &
Rationale | Based on Current Nursing Curriculum from
Chamberlain, Rasmussen, Aspen, WGU, Galen College
QUESTION 1
A nurse is caring for a patient with heart failure. Which dietary change should the
nurse recommend?
A) Increase sodium intake
B) Increase potassium intake
C) Decrease sodium intake (correct)
D) Decrease fluid intake
RATIONALE: A decrease in sodium intake helps manage fluid retention and blood
pressure in heart failure patients.
QUESTION 2
A patient is being treated for pneumonia. What is the priority nursing intervention?
A) Administer bronchodilators
B) Encourage fluid intake
C) Obtain a sputum culture (correct)
D) Provide oxygen therapy
RATIONALE: Obtaining a sputum culture is essential to identify the causative organism
and guide antibiotic therapy.
QUESTION 3
A nurse is teaching a patient about self-administration of insulin. Which statement
by the patient indicates a need for further teaching?
A) "I will rotate my injection sites."
B) "I can use any part of my body for injections."
C) "I will use the same site for every injection." (correct)
D) "I will keep my insulin in the refrigerator."
RATIONALE: Using the same site for every injection can lead to lipodystrophy; rotation
of sites is important.
QUESTION 4
A patient with diabetes is experiencing hypoglycemia. What is the priority action by
the nurse?
,A) Administer 15 grams of fast-acting carbohydrate (correct)
B) Administer glucagon
C) Call the physician
D) Provide a snack with protein
RATIONALE: Administering fast-acting carbohydrates quickly raises blood sugar levels,
which is the immediate need in hypoglycemia.
QUESTION 5
A patient is post-operative after a cholecystectomy. Which assessment finding
should the nurse report immediately?
A) Moderate abdominal pain
B) Nausea and vomiting
C) Rigid abdomen (correct)
D) Low-grade fever
RATIONALE: A rigid abdomen may indicate peritonitis or internal bleeding, which
requires immediate attention.
QUESTION 6
A nurse is caring for a patient with a newly placed tracheostomy. What is the
priority nursing intervention?
A) Provide humidified air
B) Suction the tracheostomy
C) Ensure the airway is patent (correct)
D) Change the tracheostomy ties
RATIONALE: Ensuring the airway is patent is the highest priority in patients with a
tracheostomy.
QUESTION 7
A patient with chronic obstructive pulmonary disease (COPD) is experiencing
shortness of breath. What is the best position for the nurse to assist the patient
into?
A) Supine
B) Lying flat
C) High Fowler's (correct)
D) Trendelenburg
,RATIONALE: High Fowler's position facilitates maximal lung expansion and eases
breathing in patients with COPD.
QUESTION 8
A nurse is assessing a patient with a suspected deep vein thrombosis (DVT). Which
assessment finding is most indicative of DVT?
A) Warmth and redness in the leg
B) Edema in the affected leg
C) Calf tenderness and swelling (correct)
D) Coolness of the extremity
RATIONALE: Calf tenderness and swelling are classic signs of DVT, prompting further
evaluation.
QUESTION 9
A patient with liver cirrhosis is at risk for bleeding. Which laboratory value should
the nurse monitor closely?
A) Hemoglobin
B) Hematocrit
C) Prothrombin time (PT) (correct)
D) Platelet count
RATIONALE: Prothrombin time is prolonged in liver disease due to impaired synthesis of
clotting factors.
QUESTION 10
A nurse is caring for a patient with a history of anaphylaxis. What is the most
important teaching point for this patient?
A) Avoid dairy products
B) Carry an EpiPen
C) Wear a medical alert bracelet (correct)
D) Limit exercise
RATIONALE: Wearing a medical alert bracelet informs others of the patient's allergy
history and the need for emergency intervention.
QUESTION 11
A patient with congestive heart failure is being discharged. What should the nurse
include in the discharge teaching?
, A) Increase fluid intake
B) Limit sodium intake
C) Weigh daily at the same time (correct)
D) Exercise vigorously
RATIONALE: Daily weight monitoring helps detect fluid retention early.
QUESTION 12
A nurse is caring for a patient receiving chemotherapy. Which finding requires
immediate intervention?
A) Nausea
B) Fever of 101°F (38.3°C) (correct)
C) Fatigue
D) Hair loss
RATIONALE: A fever indicates potential infection in immunocompromised patients,
requiring prompt action.
QUESTION 13
A patient with diabetes is learning about foot care. Which statement indicates a
need for further teaching?
A) "I will check my feet daily."
B) "I can use hot water to soak my feet." (correct)
C) "I should wear well-fitting shoes."
D) "I will report any sores to my doctor."
RATIONALE: Soaking feet in hot water can cause burns; this statement shows a lack of
understanding.
QUESTION 14
A nurse is monitoring a patient after a myocardial infarction. What is the priority
assessment?
A) Lung sounds
B) Heart rate
C) Blood pressure (correct)
D) Temperature
RATIONALE: Blood pressure is critical to monitor for potential complications like
cardiogenic shock.
